Registration Form

We are currently accepting application forms for the 2025-2026 school year.
How many children are you registering?*
Child 1
Child's Full Name
First Name Last Name
Child's Hebrew Name (If known)
Date of Birth

Month Day Year
Gender
School Attending
Current Grade (2024/25)
Hebrew Reading Proficiency

NoneSomewhatWell
Previous Jewish Education

YesNo
If yes, please specify
Was the child's biological mother born Jewish?

YesNo
Were there any conversions or adoptions in the family?

YesNo
If yes, please describe
Any Allergies?
CONFIDENTIAL: Any considerations, such as learning disorder or difficulty, the instructor should be aware of? Does your child receive additional resources in school?
Child 2
Child's Full Name
First Name Last Name
Child's Hebrew Name (If known)
Date of Birth

Month Day Year
Gender
School Attending
Current Grade (2024/25)
Hebrew Reading Proficiency

NoneSomewhatWell
Previous Jewish Education

YesNo
If yes, please specify
Any Allergies?
CONFIDENTIAL: Any considerations, such as learning disorder or difficulty, the instructor should be aware of? Does your child receive additional resources in school?
Child 3
Child's Full Name
First Name Last Name
Child's Hebrew Name (If known)
Date of Birth

Month Day Year
Gender
School Attending
Current Grade (2024/25)
Hebrew Reading Proficiency

NoneSomewhatWell
Previous Jewish Education

YesNo
If yes, please specify
Any Allergies?
CONFIDENTIAL: Any considerations, such as learning disorder or difficulty, the teacher should be aware of? Does your child receive additional resources in school?
Parent Information
Mother's Name
First Name Last Name
Mother's Cell
Mother's E-mail

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Father's Name
First Name Last Name
Father's Cell
Father's E-mail

Address (if different than above)

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone
Marital Status

MarriedDivorcedSingleWidowed
Does either parent have any special skill or resource to offer?
Emergency Information
Emergency Contact 1*
First Name Last Name
Emergency Contact 2
First Name Last Name
Doctor's Full Name*
Doctor's Phone Number*

Doctor's Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Additional Notable Information
Payment
$800 a child

Sibling Discount: $100 discount for each additional child registering per family. (ie: discount taken off 2nd, 3rd, 4th children)

Registration fee $55 per child.
(Please note: Your child's registration is not complete until initial payment is made and other payments are scheduled.).

For any additional questions feel free to reach out to Miriam via email at [email protected]
Total

$0.00

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Please Note:
CKids Club is a fun and engaging Jewish club for children that includes learning the Alef-Bet and Hebrew reading, exploring Jewish holidays, mitzvot, and discovering Jewish history and Torah stories. It is not a Hebrew school or Bar/Bat Mitzvah preparation program. Participation in C-Kids Clubs does not guarantee that we will officiate a Bar or Bat Mitzvah ceremony. Our Bar and Bat Mitzvah services are reserved for children who are considered Jewish according to the Halachic standards of Israel’s Chief Rabbinate.
As the parent(s) or legal guardian of the above child, I/we authorize any adult acting on behalf of Chabad of Sea Cliff - Glen Cove to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad of Sea Cliff - Glen Cove personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child to participate in all school activities, join in class and school trips on and beyond school properties and allow my child to be photographed while participating in Chabad of Sea Cliff - Glen Cove activities and that these pictures may be used for marketing purposes. Ckids Jewish Club is a project of Chabad of Sea Cliff - Glen Cove and reserves the right to terminate this registration at any time and refund the balance paid.
*

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Educate Your Child... Educate a Generation

We are currently accepting application forms for the 2025-2026 school year.

Child 1

Child 2

Child 3

Parent Information

Emergency Information

Payment